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Medication orlistat appears helpful in improving weight management for obese adolescents

When combined with diet, exercise and behavioral therapy, orlistat, a drug that decreases fat absorption, appears helpful for improving weight management in obese adolescents, compared with placebo, according to an article in the June 15 issue of JAMA.

Excess weight in adolescents is associated with increased risk of hyperlipidemia and type 2 diabetes, and its prevalence is increasing worldwide, according to background information in the article. In the United States, the proportion of adolescents with a body mass index (BMI) at or above the 95th percentile for age, a widely accepted definition of obesity in adolescents, has increased 15.5 percent to 23.4 percent in certain ethnic minorities. Overweight children are at a 15-fold greater risk of becoming overweight adults compared to children and adolescents not overweight. Pediatric obesity can be particularly difficult to treat, with long-term success depending on the type of therapy used. Orlistat is a gastrointestinal tract lipase (an enzyme) inhibitor which decreases intestinal fat absorption by up to 30 percent; in adults, the drug has a good safety profile and is generally well tolerated.

Jean-Pierre Chanoine, M.D., Ph.D., from the British Columbia Children's Hospital, Vancouver, and colleagues examined the effectiveness and safety of orlistat for weight management in adolescents, in this 54-week, randomized, double-blind study. Participants were aged 12 to 16 years and had a BMI (calculated as weight in kilograms divided by the square of height in meters) two units or more above the 95th percentile at baseline. Three hundred fifty-seven patients received 120 mg of orlistat three times daily and 182 participants received placebo three times daily for one year. Both groups were given instructions on how to maintain a reduced calorie diet, and received counseling for exercise and behavior modification (i.e., recording food intake, recognizing cues for overeating). The researchers also assessed t
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Contact: Jean Pierre Chanoine, M.D., Ph.D.
604-875-2301
JAMA and Archives Journals
14-Jun-2005


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